Sex differences and subclinical retinal injury in pediatric-onset MS

To assess retinal ganglion cell (RGC) injury and sex differences in axon loss in pediatric multiple sclerosis (MS). This is a cross-sectional evaluation of consecutive pediatric MS subjects and controls. Eyes with acute optic neuritis (ON) within 6 months of visit were excluded. Spectral domain opti...

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Veröffentlicht in:Multiple sclerosis Jg. 23; H. 3; S. 447
Hauptverfasser: Graves, Jennifer S, Chohan, Hardeep, Cedars, Benjamin, Arnow, Samuel, Yiu, Hao, Waubant, Emmanuelle, Green, Ari
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England 01.03.2017
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ISSN:1477-0970, 1477-0970
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Abstract To assess retinal ganglion cell (RGC) injury and sex differences in axon loss in pediatric multiple sclerosis (MS). This is a cross-sectional evaluation of consecutive pediatric MS subjects and controls. Eyes with acute optic neuritis (ON) within 6 months of visit were excluded. Spectral domain optical coherence tomography (OCT) included peripapillary ring and macular scans with post-acquisition segmentation of retinal layers using automated software (Heidelberg v1.8.6.0). Generalized estimating equations (GEEs) measured associations of sex, history of ON, disease duration, and age with OCT outcomes. In all, 53 MS subjects (100 eyes, median disease duration = 1.0 years, interquartile range (IQR) = 0.3, 2.5) were compared to 19 control subjects (38 eyes). Eyes with history of ON showed reduced retinal nerve fiber layer (RNFL: -26.8 µm, 95% confidence interval (CI) = -38.9, -14.8, p < 0.001) and 26% lower ganglion cell layer (GCL) volumes (-0.12 mm , 95% CI = -0.16, -0.072, p < 0.001) compared to control eyes. Non-ON MS eyes had lower temporal RNFL (-11.9 µm, 95% CI = -18.6, -5.3, p < 0.001) and GCL volumes (-0.036 mm , 95% CI = -0.06, -0.011, p = 0.004) than control eyes. In MS eyes, males versus females had lower global RNFL (-9.4 µm, 95% CI = -17.4, -1.33, p = 0.022) and in ON eyes had lower temporal quadrant RNFL (-9.6 µm, 95% CI = -15.1, -4.15, p = 0.001). Subclinical retinal injury occurs in pediatric-onset MS patients without a history of ON. As in adult-onset MS, substantial GCL thinning is present in eyes with prior ON. Finally, greater retinal axonal injury occurs in boys compared to girls.
AbstractList To assess retinal ganglion cell (RGC) injury and sex differences in axon loss in pediatric multiple sclerosis (MS). This is a cross-sectional evaluation of consecutive pediatric MS subjects and controls. Eyes with acute optic neuritis (ON) within 6 months of visit were excluded. Spectral domain optical coherence tomography (OCT) included peripapillary ring and macular scans with post-acquisition segmentation of retinal layers using automated software (Heidelberg v1.8.6.0). Generalized estimating equations (GEEs) measured associations of sex, history of ON, disease duration, and age with OCT outcomes. In all, 53 MS subjects (100 eyes, median disease duration = 1.0 years, interquartile range (IQR) = 0.3, 2.5) were compared to 19 control subjects (38 eyes). Eyes with history of ON showed reduced retinal nerve fiber layer (RNFL: -26.8 µm, 95% confidence interval (CI) = -38.9, -14.8, p < 0.001) and 26% lower ganglion cell layer (GCL) volumes (-0.12 mm , 95% CI = -0.16, -0.072, p < 0.001) compared to control eyes. Non-ON MS eyes had lower temporal RNFL (-11.9 µm, 95% CI = -18.6, -5.3, p < 0.001) and GCL volumes (-0.036 mm , 95% CI = -0.06, -0.011, p = 0.004) than control eyes. In MS eyes, males versus females had lower global RNFL (-9.4 µm, 95% CI = -17.4, -1.33, p = 0.022) and in ON eyes had lower temporal quadrant RNFL (-9.6 µm, 95% CI = -15.1, -4.15, p = 0.001). Subclinical retinal injury occurs in pediatric-onset MS patients without a history of ON. As in adult-onset MS, substantial GCL thinning is present in eyes with prior ON. Finally, greater retinal axonal injury occurs in boys compared to girls.
To assess retinal ganglion cell (RGC) injury and sex differences in axon loss in pediatric multiple sclerosis (MS).OBJECTIVETo assess retinal ganglion cell (RGC) injury and sex differences in axon loss in pediatric multiple sclerosis (MS).This is a cross-sectional evaluation of consecutive pediatric MS subjects and controls. Eyes with acute optic neuritis (ON) within 6 months of visit were excluded. Spectral domain optical coherence tomography (OCT) included peripapillary ring and macular scans with post-acquisition segmentation of retinal layers using automated software (Heidelberg v1.8.6.0). Generalized estimating equations (GEEs) measured associations of sex, history of ON, disease duration, and age with OCT outcomes.METHODSThis is a cross-sectional evaluation of consecutive pediatric MS subjects and controls. Eyes with acute optic neuritis (ON) within 6 months of visit were excluded. Spectral domain optical coherence tomography (OCT) included peripapillary ring and macular scans with post-acquisition segmentation of retinal layers using automated software (Heidelberg v1.8.6.0). Generalized estimating equations (GEEs) measured associations of sex, history of ON, disease duration, and age with OCT outcomes.In all, 53 MS subjects (100 eyes, median disease duration = 1.0 years, interquartile range (IQR) = 0.3, 2.5) were compared to 19 control subjects (38 eyes). Eyes with history of ON showed reduced retinal nerve fiber layer (RNFL: -26.8 µm, 95% confidence interval (CI) = -38.9, -14.8, p < 0.001) and 26% lower ganglion cell layer (GCL) volumes (-0.12 mm3, 95% CI = -0.16, -0.072, p < 0.001) compared to control eyes. Non-ON MS eyes had lower temporal RNFL (-11.9 µm, 95% CI = -18.6, -5.3, p < 0.001) and GCL volumes (-0.036 mm3, 95% CI = -0.06, -0.011, p = 0.004) than control eyes. In MS eyes, males versus females had lower global RNFL (-9.4 µm, 95% CI = -17.4, -1.33, p = 0.022) and in ON eyes had lower temporal quadrant RNFL (-9.6 µm, 95% CI = -15.1, -4.15, p = 0.001).RESULTSIn all, 53 MS subjects (100 eyes, median disease duration = 1.0 years, interquartile range (IQR) = 0.3, 2.5) were compared to 19 control subjects (38 eyes). Eyes with history of ON showed reduced retinal nerve fiber layer (RNFL: -26.8 µm, 95% confidence interval (CI) = -38.9, -14.8, p < 0.001) and 26% lower ganglion cell layer (GCL) volumes (-0.12 mm3, 95% CI = -0.16, -0.072, p < 0.001) compared to control eyes. Non-ON MS eyes had lower temporal RNFL (-11.9 µm, 95% CI = -18.6, -5.3, p < 0.001) and GCL volumes (-0.036 mm3, 95% CI = -0.06, -0.011, p = 0.004) than control eyes. In MS eyes, males versus females had lower global RNFL (-9.4 µm, 95% CI = -17.4, -1.33, p = 0.022) and in ON eyes had lower temporal quadrant RNFL (-9.6 µm, 95% CI = -15.1, -4.15, p = 0.001).Subclinical retinal injury occurs in pediatric-onset MS patients without a history of ON. As in adult-onset MS, substantial GCL thinning is present in eyes with prior ON. Finally, greater retinal axonal injury occurs in boys compared to girls.CONCLUSIONSubclinical retinal injury occurs in pediatric-onset MS patients without a history of ON. As in adult-onset MS, substantial GCL thinning is present in eyes with prior ON. Finally, greater retinal axonal injury occurs in boys compared to girls.
Author Cedars, Benjamin
Arnow, Samuel
Waubant, Emmanuelle
Yiu, Hao
Green, Ari
Graves, Jennifer S
Chohan, Hardeep
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  givenname: Ari
  surname: Green
  fullname: Green, Ari
  organization: Department of Neurology, University of California-San Francisco, San Francisco, CA, USA/Department of Ophthalmology, University of California-San Francisco, San Francisco, CA, USA
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multiple sclerosis
pediatric
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Snippet To assess retinal ganglion cell (RGC) injury and sex differences in axon loss in pediatric multiple sclerosis (MS). This is a cross-sectional evaluation of...
To assess retinal ganglion cell (RGC) injury and sex differences in axon loss in pediatric multiple sclerosis (MS).OBJECTIVETo assess retinal ganglion cell...
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StartPage 447
SubjectTerms Adolescent
Age of Onset
Axons - pathology
Child
Child, Preschool
Cross-Sectional Studies
Female
Humans
Male
Multiple Sclerosis - complications
Multiple Sclerosis - diagnostic imaging
Multiple Sclerosis - pathology
Nerve Fibers - pathology
Optic Neuritis - diagnostic imaging
Optic Neuritis - etiology
Retina - injuries
Retina - pathology
Retinal Ganglion Cells - pathology
Sex Characteristics
Tomography, Optical Coherence - methods
Title Sex differences and subclinical retinal injury in pediatric-onset MS
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